robert atkins, cardiologist and author of the bestselling diet book dr. atkins’ new diet revolution, was dismissed as capricious or worse by most experts. he promoted carbohydrate restriction and a diet high in protein and fat, urging patients to “eat the hamburger and throw away the bun.” His theories sparked a bitter dispute between those who would limit fat and those who would limit carbohydrates.
atkins’s followers saw him as a brave david who stood up to the goliath of the establishment with his misconceptions and vested interests. Shunned by the medical community, Atkins appealed directly to the public. Popular support for the Atkins diet grew at an astonishing rate. His book Dr Atkins’ Diet Revolution, first published in 1972 and republished 20 years later as Dr Atkins’ New Diet Revolution, sold 12 million copies, making it the best-selling diet book in history.
although atkins is relied on by millions of people struggling with being overweight, studies of popular diets have never been conducted by the us national institutes of health (nih), until recently. The stakes are high: 325,000 deaths in the United States each year are attributed to complications of obesity. direct health care costs are pegged at $39 billion to $52 billion annually. spending in the diet and weight loss industry is estimated at $50 billion a year.
Both Atkins, in the carbohydrate restriction camp, and his detractors, in the fat restriction camp, espouse “glycemic index” theories or track surrogate markers such as cholesterol levels and urinary excretion of cholesterol. Calcium in Support of Your Diets However, there is little long-term data on actual clinical endpoints, such as rates of death, heart attack, or cancer, using intention-to-treat analysis of weight-loss diets. p>
bonnie liebman, director of nutrition at the center for science in the public interest, says most nih studies have focused on varying the composition of the diet while keeping calories constant. “That type of study fails to mimic the real world because it doesn’t measure the impact of fat, protein, or carbohydrate on appetite. feeding study participants three meals a day is very different from telling them to go out and choose a diet of foods high in fat, protein, or carbohydrates. Given the fact that millions of people were already following the Atkins diet, it was irresponsible for the government not to prove its safety, let alone its efficacy.”
For most of his career, Atkins resisted scientific scrutiny, saying he was a doctor, not a researcher. he also displayed a dislike or lack of appreciation for the scientific method. The doctor. Eric Westman, an associate professor of medicine at Duke University, said that when he approached Atkins for funding to study the Atkins diet, Atkins responded, “Why should I support a study? it’s all in my book.” Westman said, “I’ve read his book and it’s all anecdotal.” atkins replied, “but i know what a study will show.”
Atkins said conventional medicine’s demand for evidence simply worked to “keep it at its current level of ineptitude.” Atkins’ defenders argue that these are simply the words of a man who distrusted the biases of conventional medicine rather than a general rejection of science.
in the end, atkins finally agreed that clinical trials might be a good idea. He founded the Atkins Foundation with his wife, Veronica, and endowed her with more than $3 million to study “controlled carbohydrate nutritional protocols.” Foundation grants have been awarded to Duke (for the Westman study), Harvard, Albert Einstein College of Medicine, and Ball State University.
To the surprise of many, the results of the Duke randomized controlled trial comparing a low-carbohydrate diet with a low-fat diet, presented at the American Heart Association annual meeting in Chicago in November 2002, showed that patients on a high-fat diet not only lost weight, but also lowered their lipid levels. These results were widely heralded in the media as the long-awaited “vindication” of Atkins and his diet.
but even atkins funded researchers are more circumspect. george blackburn, director of the center for the study of nutrition in medicine at beth israel in boston, says, “anyone who says atkins is vindicated is misguided.” Westman is similarly cautious, saying, “We’ve got a long way to go before we say this is a good thing.”
skeptics are concerned in part because of the lack of long-term studies needed to answer questions raised about the safety of the atkins diet, including whether it will promote osteoporosis, colon cancer, heart disease, damage kidney disease and gout, as critics charge.
Atkins, described by supporters as “driven,” devoted nearly all of his time to his work. In the end, Atkins left his mark because, by challenging established medical dogma and creating a multi-billion dollar company, he created so much controversy that he ultimately could not be ignored.
robert coleman atkins, founder and director of the atkins center for complementary medicine, new york city, united states (b columbus, ohio, 1930; q cornell university school of medicine, new york city, new york, 1955), died of complications from a head injury on April 17, 2003 after falling on a New York sidewalk.